title: Irinotecan and bevacizumab in recurrent glioblastoma multiforme.
abstract: BACKGROUND
  Glioblastoma multiforme (GBM) is the most common high grade primary brain tumor in adults. Despite significant advances in treatment, the prognosis remains poor. Bevacizumab (BVZ) and irinotecan (CPT-11) are currently being investigated in the treatment of GBM patients. Although treatment with BVZ and irinotecan provides impressive response rates (RR), it is still uncertain if this treatment translates into improved clinical benefit in GBM patients.
  
  
  METHODS
  This review discusses the clinical efficacy, safety and difficulties regarding response evaluation when treating with BVZ and CPT-11 in recurrent GBM. Particular attention is placed on the literature and a discussion on whether treatment with BVZ and CPT-11 improves clinical outcome. Antiangiogenic treatment has led to difficulties when evaluating objective response by the conventional MacDonald criteria. In the present paper the authors discuss selected key aspects of this treatment modality. A literature search was performed using PubMed in February 2011.
  
  
  CONCLUSIONS
  BVZ + irinotecan leads to high RR and to an increased 6-month progression-free survival. However, no improvement in median overall survival has been observed compared with conventional chemotherapy. Nevertheless, the GBM patients who respond to treatment with BVZ and irinotecan have survived significantly longer than non-responders, indicating that it could be beneficial for a selection of patients to receive this treatment.
authors.affiliation: Copenhagen University Hospital, The Finsencenter, Department of Oncology, Blegdamsvej 9, DK 2100 Copenhagen, Denmark. jan.nyrop.jakobsen@rh.regionh.dk
authors.forename: Jan Nyrop
authors.initials: JN
authors.lastname: Jakobsen
authors.forename: Benedikte
authors.initials: B
authors.lastname: Hasselbalch
authors.forename: Marie-Thérése
authors.initials: MT
authors.lastname: Stockhausen
authors.forename: Ulrik
authors.initials: U
authors.lastname: Lassen
authors.forename: Hans Skovgaard
authors.initials: HS
authors.lastname: Poulsen
mesh_terms: D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000068258:Bevacizumab; D001932:Brain Neoplasms / Q000188:drug therapy*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005909:Glioblastoma / Q000188:drug therapy*; D006801:Humans; D000077146:Irinotecan; D008875:Middle Aged; D012008:Recurrence; D016019:Survival Analysis
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D000068258:Bevacizumab; D000077146:Irinotecan; D002166:Camptothecin